腰椎椎弓根对应横断面椎体松质骨CT值与BMD值、T值的相关性

The correlation between CT attenuation value, BMD, and T-score of the lumbar pedicle corresponding to cross section

目的对中国女性患者腰椎椎弓根对应横断面椎体松质骨CT值与年龄、双能X线骨密度值以及T值的相关性进行研究,以期为脊柱外科椎弓根螺钉置入术术前评估钉道骨质量提供参考。方法将465例因腰腿痛住院的女性患者纳入本研究,所有患者均行腰椎CT及骨密度检查。研究人员测量了腰1~4椎弓根中部对应横截面上椎体松质骨的CT值,同时用双能X线骨密度仪(DXA)测量了腰1~4椎体的骨密度(BMD),并计算了404名绝经后女性研究对象的T值。将腰1~4椎弓根对应横断面椎体松质骨CT值、年龄、BMD以及T值进行统计学分析。结果椎弓根对应横断面椎体松质骨CT值随着年龄增长而不断下降,各年龄组间差异有统计学意义(P<0.001);②腰1~4椎弓根对应横断面椎体CT值与BMD、T值均呈显著正相关(P<0.001),腰4椎体相关性较其他三个椎体差。③根据T值大小,将其中404名女性患者分为骨量正常、骨量减少及骨质疏松3组。组间两两进行比较,椎弓根对应横断面椎体CT值:骨质疏松症组<骨量减少组<骨量正常组,差异具有统计学意义(P<0.001)。结论女性腰椎椎弓根对应横断面椎体松质骨CT值随着年龄增大而逐渐减小,与BMD值、T值呈现显著正相关。其中腰4椎体由于更容易发生退变导致其CT值与BMD值、T值相关性较差。

Objective To study the correlation between computed tomography(CT)attenuation values of cancellous bone corresponding to lumbar pedicle and age,bone mineral density(BMD),and T-score in Chinese female patients,in order to provide reference for evaluating the bone quality of screw canal before pedicle screw placement in spinal surgery.Methods The study included 465 women hospitalized with lumbago and leg pain,all of whom underwent lumbar CT and BMD.CT values of cancellous bone of the vertebral body at the corresponding cross section of the lumbar 1 to 4 pedicles were measured.BMD of the lumbar 1 to 4 vertebral body was measured using dual energy X-ray absorptiometry(DXA)and T-scores were calculated in 404 postmenopausal women.CT attenuation values,age,and BMD and T-score of cancellous bone of vertebral body corresponding to lumbar 1-4 pedicles were statistically analyzed.Results CT attenuation values of cancellous bone of the vertebral pedicle in cross section decreased with age,and there were statistically significant differences among different age groups(P<0.001).②CT attenuation values of the vertebral body corresponding to the 1-4 lumbar pedicle were significantly positively correlated with BMD and T-score(P<0.001),and the correlation of lumbar 4 vertebral body was worse than the other three vertebral bodies.③According to T-scores,404 female patients were divided into three groups:normal bone mass group,osteopenia,and osteoporosis group,respectively.CT attenuation values of the vertebral pedicle corresponding to vertebral body in cross section were as follows:osteoporosis group<osteopenia<normal bone mass group,and the difference was statistically significant(P<0.001).Conclusion CT attenuation values of cancellous bone in the transverse section of female lumbar pedicle decrease with age,and there is a significant positive correlation with BMD and T-score measured by DXA.Among them,the lumbar 4 vertebral is more prone to degeneration,Results ing in poor correlation between CT attenuation value and BMD value and T-score.